River Rock Family Practice PC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

Legal business name

RIVER ROCK FAMILY PRACTICE PC

Practice address

3144 State St
Medford, OR 97504-8450

Phone

(541) 226-9840

NPI assigned

Nov 22, 2019

Organization subpart

Yes

Parent organization

RIVER ROCK FAMILY PRACTICE PCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tammy Harrison

Title

Secretary

Phone

(541) 226-9840

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in OR

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• River Rock Family Practice PC

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1184052136

  O20140228000203

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

River Rock Family Practice

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• River Rock Family Practice PC

  • Family Nurse Practitioner
  • Grants Pass, OR
  • NPI 1184052136
  NPPES parent name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey James Cole, FNP

  • Family Nurse Practitioner
  • Medford, OR
  • NPI 1982472601
  NPD
• Mason Clarke Harrison, F.N.P.

  • Family Nurse Practitioner
  • Medford, OR
  • NPI 1356355846
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1053957225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3144 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-226-9840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3144 STATE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975048450",
            "telephone_number": "541-226-9840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER ROCK FAMILY PRACTICE PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RIVER ROCK FAMILY PRACTICE PC",
        "enumeration_date": "2019-11-22",
        "last_updated": "2023-03-07",
        "certification_date": "2021-09-29",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "541-226-9840"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMAP",
            "identifier": "026845",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FNPC",
            "identifier": "200550153NP",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1356355846",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Henry Ritacca, DDS
• Tracy K Ritchie, NNP
• Leslie Marie Ritner-Bogue, L.C.S.W.
• Nicole Ritterbush
• Martin Rivas
• Martha Rivera Canjura
• Rivera Health & Wellness
• Beatriz Prisilla Rivera Rodriguez, M.D
• Maria Elena Rivera, FNP
• Pamela Jean Rivera, PMHNP

• Family Nurse Practitioner in Medford, OR
• Providers in Medford, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.